Kinesiophobia: This is living with fear of moving

The kinesiofobia is a term that refers literally to “fear of movement”. It is a pathological fear to make movements, even if they are very small movements in the most serious cases, for fear that these will be painful.

It is a situation that is generated in pathologies that occur with pain, either acute (after an accident …) or chronic (low back pain, cervical …). It is a problem that has a physical component (structures affected) but also of behavior, belief and catastrophism .

Do not move the injured area: from normal to pathological

When suffering an injury, it is a natural tendency to limit the movement of the damaged area , to favor its recovery. Kinesiophobia occurs when the precaution is excessive , beyond what is healthy, and is afraid to make even minimal movements to think that these can worsen the injury.

There are also cases in which exercise or treatment is recommended to improve the lesion, but kinesiophobia prevents the person from participating in these types of treatments, because they think they can be harmful.

The catastrophism is thoughts about damage or problems arising from exercise or movement. It makes the person believe that any exercise or movement will worsen the injury , moves with fear, and that creates rigidity, in addition to postures and pathological movements, which perpetuate pain and problems . It is a vicious circle.

I knew the case of a person who had suffered a traffic accident, which caused a neck injury. This person, once recovered, used a cervical collar to drive , for fear of an accident and that the neck would be injured again. He presented limitation of the cervical mobility as well as other problems derived from this hypervigilante attitude.

The movement is usually a good treatment

And it is precisely that we have named it on several occasions: in case of chronic pain, not only is recommended exercise: it is necessary, essential, to reduce the painful sensation and recover the quality of life.

In case of acute injuries, there is also the indication of moving from passive treatment to active techniques, which includes exercise and movement. The important thing is that in each case, the exercise and the movements are adapted, depending on the pain, the fear … To do it little by little and according to the concrete needs.

There are scales and assessments to detect catastrophism and kinesiophobia. In terms of treatment, measures that combine progressive exposure to the problem are usually employed.

This consists of reproducing gestures and movements that the patient thinks they will not be able to do, and that will generate pain. They are done in a gentle, controlled way and, little by little, adding weight or difficulty. They often reproduce everyday situations, to teach the person who is able to make a normal life without having to be constantly worried about the pain.

I have seen video cases of people who literally cry in fear when they do these kinds of exercises, such as taking out bags from the trunk of the car, or stooping to pick up an object from the ground. Thinking about doing these movements already generated terror, but, in the exercise, you see how, little by little, they are able to do it (with the help of the physiotherapists who indicated the progression).

Psychological interventions are also often necessary to redirect these negative and catastrophic thoughts and make it appear that movement is something natural and that our body is designed to move and to support efforts